Provider Demographics
NPI:1316094865
Name:NAWAZ, SHAH (MD)
Entity type:Individual
Prefix:DR
First Name:SHAH
Middle Name:
Last Name:NAWAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4 RIVERVIEW RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND FLS
Mailing Address - State:NY
Mailing Address - Zip Code:10928-2200
Mailing Address - Country:US
Mailing Address - Phone:845-245-4636
Mailing Address - Fax:845-205-4691
Practice Address - Street 1:4 RIVERVIEW RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND FLS
Practice Address - State:NY
Practice Address - Zip Code:10928-2200
Practice Address - Country:US
Practice Address - Phone:845-245-4636
Practice Address - Fax:845-205-4691
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY237940207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine